补肾化痰汤联合二甲双胍对多囊卵巢综合征患者胰岛素抵抗、糖脂代谢的影响

目的:观察补肾化痰汤联合二甲双胍治疗多囊卵巢综合征(polycystic ovarian syndrome,PCOS)的临床疗效,并观察其对胰岛素抵抗、糖脂代谢的改善作用。方法:140例PCOS患者按照随机数字表法分为观察组和对照组,每组各70例。对照组给予二甲双胍,观察组在对照组治疗基础上给予补肾化痰汤。比较两组患者治疗前后卵巢、卵泡情况,性激素指标:总睾酮(total testosterone,T)、黄体生成素(luteinizing homone,LH)、尿促卵泡素(follicle-stimulating hormone,FSH),血糖代谢指标:血清糖化血红蛋白(glycosylated hemoglobin,HbA1c)、空腹胰岛素(fasting insulin,FINS)、空腹血糖(fasting blood-glucose,FBG),血脂代谢指标:总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin,LDL-C)、三酰甘油(triacylglycerol,TG)和胰岛素抵抗指数(insulin resistance index,IRI),并比较临床疗效。结果:治疗后两组患者左侧、右侧卵巢体积,窦卵泡数量均明显下降(P<0.05);且观察组治疗后显著低于对照组治疗后(P<0.05)。治疗后两组患者T、LH、FSH水平均明显下降(P<0.05),且观察组治疗后显著低于对照组治疗后(P<0.05)。治疗后两组患者HbA1c、FINS、IRI均显著下降(P<0.05),且观察组治疗后显著低于对照组治疗后(P<0.05)。治疗后两组患者TC、TG均明显降低(P<0.05),且观察组治疗后显著低于对照组治疗后(P<0.05);治疗后观察组HDL-C明显升高(P<0.05);治疗前后两组LDL-C均无显著变化。治疗后两组患者中医证候积分均明显降低(P<0.05),且观察组治疗后显著低于对照组治疗后(P<0.05)。观察组有效率显著高于对照组(P<0.05)。结论:补肾化痰汤联合二甲双胍能显著降低PCOS患者胰岛素抵抗,降低性激素水平,改善血糖、血脂代谢,临床治疗效果显著。

Effect of Bushen Huatan Decoction Combined with Metformin on Insulin Resistance,Glucose and Lipid Metabolism in Patients with Polycystic Ovarian Syndrome

Objective:To observe the clinical efficacy of Bushen Huatan Decoction combined with metformin in the treatment of polycystic ovarian syndrome(PCOS),and to observe its improvement on insulin resistance,glucose and lipid metabolism.Methods:140 PCOS patients were divided into observation group and control group according to the random number table method,70 cases in each group.The control group was given metformin,and the observation group was given Bushen Huatan Decoction on the basis of the treatment of the control group.Before and after treatment,the ovarian and follicular conditions of the two groups were compared.The sex hormone indexes included:total testosterone(T),luteinizing homone(LH),follicle-stimulating hormone(FSH),blood glucose metabolism indexes:glycosylated hemoglobin(HbA1 c),fasting insulin(FINS),fasting blood-glucose(FBG),lipid metabolism indexes:total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triacylglycerol(TG)and insulin resistance index(IRI),and compare the clinical efficacy.Results:After treatment,the volume of left and right ovaries and the number of antral follicles in the two groups decreased significantly(P<0.05),and the observation group was significantly lower than the control group(P<0.05).After treatment,the levels of T,LH and FSH in the two groups decreased significantly(P<0.05),and the level in the observation group was significantly lower than that in the control group(P<0.05).After treatment,HbA1 c,FINS and IRI of the two groups decreased significantly(P<0.05),and the observation group was significantly lower than the control group(P<0.05).After treatment,TC and TG of the two groups were significantly reduced(P<0.05),and the observation group was significantly lower than the control group after treatment(P<0.05);after treatment,HDL-C of the observation group was significantly increased(P<0.05);before and after treatment,LDL-C of the two groups had no significant change.After treatment,the TCM syndrome scores of the two groups were significantly reduced(P<0.05),and the observation group was significantly lower than the control group(P<0.05).The effective rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:Bushen Huatan Decoction combined with metformin can significantly reduce the insulin resistance of PCOS patients,reduce the level of sex hormones,improve the metabolism of blood glucose and lipids,and the clinical treatment effect is significant.